Offered through Medicaid and the Children’s Health Insurance Program (CHIP).
If you are eligible for health coverage from your employer but are unable to afford the premiums, some states, including Wisconsin, have premium assistance programs that can help pay for coverage using funds from the Medicaid or CHIP programs. In Wisconsin, these health care programs are known as BadgerCare Plus. The premium assistance program is known in Wisconsin as Health Insurance Premium Payment (HIPP).
In order to enroll in HIPP, you first have to enroll in the BadgerCare Plus program. If you or your dependents are already enrolled in BadgerCare Plus, the state will automatically determine your eligibility for HIPP and contact you if HIPP is available for your family.
If you or your dependents are NOT currently enrolled in BadgerCare Plus and you think you or any of your dependents might be eligible for this program, you can contact your local county or tribal human services or social services office. You may also check Wisconsin’s ACCESS website to find out if you may qualify and to apply for the program online. The link to ACCESS is access.wisconsin.gov/, or you may call 1-800-362-3002 to request that an application form be mailed to you. Please note that if the employer pays at least 80% of the cost of the premiums for employees and their dependents, they may not qualify for BadgerCare Plus. If you reside outside Wisconsin, you can dial 1-877-KIDS NOW or visit their website at www.insurekidsnow.gov to find out how to apply in your state.
If it is determined that you or your dependents are eligible for HIPP under BadgerCare Plus, your employer’s health plan is required to permit you and your dependents to enroll in the plan—as long as you and your dependents are eligible, but not already enrolled in the employer’s plan. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance.
For more information on special enrollment rights, you can contact either of the following departments:
U.S. Department of Labor
Employee Benefits Security Administration
U.S. Department of Health and Human Services
Centers for Medicare and Medicaid Services
1-877-267-2323, ext. 61565